Why 7 Deadly Diseases Strike Blacks Most

African-Americans and Heart Disease, Stroke continued...

Clinical trials show blacks and whites respond differently to treatments for
high blood pressure. Indeed, treatment guidelines suggest that doctors should
consider different drugs based on a patient's race.

But Yancey says that a closer look at the data shows that race tends to be a
marker for more complicated high blood pressure treatment.

"Data suggests that all therapies do equally well -- but patients at
higher risk need more intensive therapy," he says.

A similar situation exists for heart failure. A promising treatment for
heart failure didn't seem to be working -- until researchers noticed that it
worked much better for black patients than for white patients. A study of black
patients confirmed this finding -- and provided tantalizing evidence that the
drug will help patients of all races with certain disease characteristics.

"The way this discussion of race differences has been helpful for the
whole field of cardiology, is it is exposing new treatment options for all
people with heart failure, African-American and Caucasian," Yancy says.

Black Americans and Diabetes

Black Americans -- and Mexican-Americans -- have twice the risk of diabetes
as white Americans. In addition, blacks with diabetes have more serious
complications -- such as loss of vision, loss of limbs, and kidney failure --
than whites, notes Maudene Nelson, RD, certified diabetes educator at Naomi
Barry Diabetes Center at Columbia University.

"The theory is that maybe it is access to health care, or maybe a
cultural fatalism -- thinking, 'It is God's will,' or, 'My family had it so I
have it' -- not a sense of something I can have an impact on so it won't hurt
me," Nelson tells WebMD. "But more and more there is thinking it is
something that makes blacks genetically more susceptible. It is hard to tell
how much of it is what."

The Forgotten Killer

There is, indeed, evidence that African-Americans may have a genetic
susceptibility to diabetes. Even so, Nelson says, the real problem is
empowering patients to keep their diabetes under control.

"Patients often have the sense that they are not as much in charge of
managing their diabetes as their doctor," Nelson says. "Where I work,
in various settings, there is an emphasis on patients. We say this is what your
blood sugar is; this is what influences your blood sugar; you have to remember
to take your meds. So as a diabetes educator I know there has to be an emphasis
on patients putting out more effort to manage their own health."